tbuckley/cabot-search huggingface dataset:
Abstract P243: Perceived Barriers and Facilitators to Healthy Eating in Pregnant People With Hypertension or at Risk for Hypertensive Disorders of Pregnancy
Authors: Sravya Shankara, Akanksha Nagarkar, Diana Sibai, Gianna Wilkie, Stephenie C Lemon, Lara Kovell
Journal: Circulation (2023)

Introduction: Heart-healthy diets are important in preventing hypertension (HTN) and hypertensive disorders of pregnancy (HDP), leading causes of preventable maternal mortality. However, perspectives of pregnant people with these conditions on barriers and facilitators of healthy eating are not well established. This study explored these experiences through qualitative feedback. Hypothesis: There are pregnancy-specific barriers and facilitators impacting healthy eating in people with HTN or at risk for HDP. Methods: Pregnant people with HTN or at risk for HDP were recruited from a large academic medical center for an electronic survey assessing barriers and facilitators to healthy eating. Participants answered open-ended questions about barriers to healthy diets and agents for change. Qualitative responses were analyzed using thematic analysis. Results: Of 46 participants (mean age 31.6 (SD 5.5) years, 35.1% Hispanic), 71.7% (33) responded to the question about barriers to healthy eating, with 56.5% (26) reporting specific barriers and 15.2% (7) reporting no barriers. Major themes for barriers included: (1) lack of education on what is “healthy;” (2) intrinsic factors (i.e., motivation, portion control, food cravings, and food aversions); (3) lack of access due to social determinants (i.e., time, finance, housing, culture and social factors); and (4) current health problems. Furthermore, 67.4% described facilitators to support healthy eating ( Table ), with themes of (1) external support, (2) discipline/routine; (3) increased affordability; and (4) menu/grocery guidance. Conclusion: Given lack of access and food preferences were common barriers to healthy eating, pregnant people with HTN or those at risk for HDP may benefit from food insecurity screening and individualized guidance from healthcare professionals. With personalized meal plans, specific recipes, and ingredient lists attainable in terms of cost, time, and social/cultural factors, these patients may be better supported for healthy eating.
Abstract P242: Accuracy of a Self-Report Screening Tool for Identifying Pregnant People With High Sedentary Behavior
Authors: Bethany Barone Gibbs, Andrea Kozai, Shannon McAdoo, Joshua Paley, Alisse Hauspurg, Keliann Davis, Janet M Catov
Journal: Circulation (2023)

Introduction: High levels of sedentary behavior (SB) are emerging as a distinct risk factor in pregnancy for poor maternal-fetal health outcomes. Thigh-worn accelerometry is ideal for quantifying SB but has high cost and participant burden; simple screening questions that could quickly identify those with high SB in clinical or research settings are desirable. We aimed to evaluate the accuracy of self-report screening questions for identifying pregnant participants with high SB. Methods: This secondary analysis used baseline data from the S edentary Behavior Reduction in Pr egnancy In tervention (SPRING) feasibility trial. During eligibility screening, participants in their first trimester met at least one of four study-developed, self-reported criteria that put them at risk for high SB: 1) mostly sitting job ≥ 30 h/week; 2) mostly sitting job &lt;30 h/week and reporting sitting ≥ ½ of non-work time; 3) did not work but reported sitting ≥ ¾ of time; and 4) &lt;6,000 steps/d from a wearable device. Eligible participants then underwent baseline SB assessment using a thigh-worn accelerometer (activPAL3, 7 d x 24 h). The proportion of participants meeting evidence-based definitions for high SB were calculated for each criterion. Definitions of high SB included: SB &gt; 10 h/d (+10h), SB &gt; 66.7% of waking time (+66.7%), and &lt; 6,000 steps per day (low steps). Results: Participants (n=51) enrolled in the study with mean (SD) age=32 (4) years, 82% White, and 84% with a college degree or greater. Of these, n=50 had valid objective SB data at baseline. On average, participants met high SB definitions with mean (SD) SB of 10.5 (1.5) hours per day, 77% (11%) of waking time in SB, and with 5,646 (2,954) steps per day. Among those with a mostly sitting job ≥ 30 h/week (n=33), 66% were above the +10h definition, 71% met the +66.7% definition, and 57% met the low steps definition. For participants with a mostly sitting but &lt;30 h/week job (n=7) and high sitting otherwise, 57% met the +10h definition, 100% met the +66.7% definition, and 71% met the low steps definition. Participants who did not work and reported ¾ time in SB (n=5) met each definition 80% of the time. Participants who reported &lt;6000 steps per day from a wearable (n=3) met all definitions 66.7% of the time. Those below the +10h SB threshold had mean (range) SB of 8.7 (7.5 to 9.4) h/d, those below the +67% SB threshold were sedentary 57.9% (51.1% to 61.3%) of the time, and those above the low steps threshold had 9,478 (6023 to 14,751) steps per day. Conclusions: Screening questions mostly identified participants who were highly sedentary, though approximately one in three did not meet thresholds for objectively-measured high SB. Future research refining screening questions is needed to improve the accuracy of identifying pregnant people with high SB by self-report, who may be at higher risk of adverse pregnancy outcomes.
Abstract P531: Arterial Stiffness and Vasomotor Symptoms: Key Factors Related to 10-year Atherosclerotic Cardiovascular Disease Risk in Perimenopausal Latinas
Authors: Valentina Marginean, Andrea Cazales, Latesha K. K Harris, Lee Stoner, Cheryl Giscombe, Krista Perreira, Yamnia I Cortes
Journal: Circulation (2023)

Background: Atherosclerotic cardiovascular disease (ASCVD) is the leading cause of death in women in the United States and risk factors increase with menopause. Midlife Latinas have a more adverse ASCVD risk profile than non-Latina White women but remain underrepresented in research. Identifying risk factors and assessing outcomes are necessary to address the primary prevention of ASCVD in this population. Thus, the aim of this analysis was to identify factors related to 10-year ASCVD risk in midlife Latinas. Methods: We conducted a cross-sectional analysis using baseline data from 30 participants enrolled in a pilot study designed to reduce ASCVD risk in perimenopausal Latinas. The women were aged 40-60 years, free of ASCVD, and without hormone therapy use in the previous three months. Sociocultural, behavioral, and reproductive factors (e.g., age, education, acculturation, perceived stress, physical activity, age at menarche) were self-reported using an interviewer-administered questionnaire. Carotid-femoral pulse wave velocity (cfPWV) and physical and anthropometric measures (e.g., weight, waist circumference, blood pressure, lipid profile) were collected during a clinical exam. The 10-year ASCVD risk score was determined using the American College of Cardiology ASCVD Risk Estimator tool. We assessed factors related to 10-year ASCVD risk using linear regression models and adjusted for factors associated with the outcome at p&lt;0.1. Results: Participants were on average aged 46.8 ± 4.2 years, 48% had less than a high school education, and 97% were born outside of the continental United States. The mean cfPWV was 6.8 ± 1.1 m/s, and the mean 10-year ASCVD risk was 1.4% ± 0.97. In fully adjusted models, we found that higher cfPWV (ß [SE]= 0.48 [0.22], p=0.04) and experiencing any vasomotor symptoms in the previous two weeks (ß [SE]= 1.4 [0.44], p=0.005) were associated with greater 10-year ASCVD risk. Conclusions: Though the 10-year ASCVD risk was relatively low (&lt;5%), we found that increased cfPWV and a report of vasomotor symptoms (hot flashes, night sweats) were associated with greater 10-year ASCVD risk in perimenopausal Latinas. These preliminary data indicate that cfPWV and vasomotor symptoms may be important factors to consider for early risk stratification in midlife Latina women.
Abstract P235: The Association Between Neighborhood Walkability and Physical Activity in a Behavioral Weight Loss Trial Testing the Addition of Remotely Delivered Feedback Messages to Self-Monitoring
Authors: Jacob K Kariuki, Zhadyra Bizhanova, Molly Conroy, Lora E Burke, Jessica Cheng, Britney Beatrice, Susan M Sereika
Journal: Circulation (2023)

Background: Adding feedback messages (FB) to self-monitoring (SM) may reinforce behavior change. However, socio-environmental conditions (e.g., limited access to parks and low walkability) may limit one’s ability to respond to FB focused on physical activity (PA). Hypothesis: Residents of high walkability neighborhoods will achieve higher PA levels at 12 months than those in low walkability neighborhoods regardless of whether FB was randomly assigned. Methods: This is a secondary analysis of a 12-month behavioral weight loss trial, where adults with overweight or obesity were randomized to SM+FB (n=251) or SM alone (n=251). The SM+FB group received a smartphone pop-up message every other day tailored to their PA data. Assessment included neighborhood walkability via Smart Walk Score (low [&lt;50] vs. high [≥50]), moderate to vigorous PA (MVPA) minutes and step count via Fitbit Charge 2™, and weight via digital smart scales. We report adjusted regression coefficients (b) with 95% confidence intervals from linear mixed modeling. To normalize the residual distribution, we applied a natural log transformation (ln) to MVPA. Results: Participants (N=502) were primarily white (82.5%), female (79.5%), well-educated (16.4±2.8 years), mean age of 45±14.4 years with a body mass index (BMI) of 33.10±3.93 kg/m 2 . Compared to those from neighborhoods with high walkability, participants from neighborhoods with low walkability were more likely to be White (75.3% vs. 87.8%, P ==.0003) and older (41.4±14.7 vs. 47.7±13.6 years, P &lt;.0001) at baseline. After adjusting for these characteristics, baseline BMI and exercise self-efficacy, neighborhood walkability did not moderate the effect of treatment assignment on lnMVPA (b±SE=-0.20±0.15, P =.170) or steps (b±SE=-816.48±484.83, P =.092) over 12 months. lnMVPA (b±SE=0.12±0.10, P =.244) and steps (b±SE=415.05±344.50, P =.228) were on average similar between walkability groups. Both lnMVPA (b 6mo ±SE=0.003±0.07, P =.968; b 12mo ±SE=-0.23±0.08, P =.009) and steps (b 6mo ±SE=-416.18±195.68, P =.034; b 12mo ±SE=-1443.75±227.49, P &lt;.0001) declined over time. On average, the SM+FB group had greater lnMVPA (b±SE=0.23±0.12, P =.047) and marginally greater number of steps (b±SE=674.84±392.91, P =.086) than SM group. There were no significant interactions for group and time or group, time, and walkability ( P ≥.05). Conclusion: On average, FB had a small but significant positive impact on PA over 12 months, but neighborhood walkability did not moderate the treatment effect of FB on PA. The small effect of FB on PA may have limited our ability to detect moderation of neighborhood walkability on the treatment effects of FB on PA. Future studies need to replicate this analysis in a trial with larger treatment effects and a more diverse sample.
Abstract P104: Association of Thyroid Peroxidase Antibodies and Mortality Risk in Participants of the ELSA-Brasil Cohort Study
Authors: Vandrize Meneghini, William Tebar, Itamar S Santos, Carolina Janovsky, Paulo A Lotufo, Alessandra C Goulart, Isabela M Bensenor
Journal: Circulation (2023)

Introduction: Thyroid peroxidase antibodies (TPOAb) has been considered a new indicator of low-grade inflammation. The presence of TPOAb was associated with a higher risk of cardiovascular diseases and mortality in previous studies. Hypothesis: We assessed the hypothesis that there is an association of TPOAb and risk of mortality in middle-aged participants from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Methods: Baseline data of 6,115 men and 7,265 women (median age of 50 years-old) were analyzed. Fasting serum TPOAb levels were determined and categorized as detectable (&gt; 5.00 IU/mL) and positive (≥ 34.00 IU/mL). All-cause, cardiovascular, and cancer-related mortality data up to December 2018 were confirmed by death certificate. The association of TPOAb levels, detectability and positivity with mortality was determined by Cox regression, using hazard ratios (HR) and 95% confidence intervals (CI). The final model was adjusted for age, sex, research center, TSH, smoking status, natural log transformed (ln) BMI, alcohol intake, diabetes mellitus, (ln) serum CRP, (ln) serum LDL cholesterol, and hypertension. Results: After a median follow-up of 9 years, the number of events was 296, 86 and 112 for men, and 182, 50, and 85 for women, for all-cause, cardiovascular and cancer-related mortality, respectively. For men, higher levels of TPOAb were significantly associated with cancer-related mortality (HR: 1.25; CI: 1.00-1.57; p=0.049). There was no association of TPOAb levels with all-cause (HR: 1.07; CI: 0.92-1.25) and cardiovascular (HR: 0.73; CI: 0.50-1.08) mortality risk; neither of TPOAb positivity and detectability with any overall or specific mortality risk (p&gt;0.05). For women, the results showed no significant association of TPOAb levels with all-cause (HR: 1.10; CI: 0.97-1.25), cardiovascular (HR: 1.05; CI: 0.81-1.35), and cancer-related (HR: 1.08; CI: 0.89-1.31) mortality. No significant associations were seen between TPOAb detectability and positivity and mortality risk (p&gt;0.05). Conclusions: In conclusion, higher levels of TPOAb were associated with a trend for increased risk of cancer-related mortality among men. Despite this interesting association, a longer period of follow-up is necessary to confirm those results. ELSA-Brasil is a cohort with relatively younger participants and low rates of mortality.
Abstract P236: Neighborhood Socioeconomic Status and Functional Status Impairment in Late-Life: The Atherosclerosis Risk in Communities (ARIC) Study
Authors: Sierra Patterson, Priya Palta, Pablo Martinez-Amezcua, Mark Lee, Anna Kucharska-Newton
Journal: Circulation (2023)

Introduction: Neighborhood characteristics and physical activity levels may impact physical function. The present study examined the relationship between neighborhood socioeconomic status (NSES) and functional status impairment among older men and women and examined whether this relationship differed by physical activity. Hypothesis: Compared to those with high levels of NSES, participants with low NSES will have higher odds of functional impairment in late life. This association will be modified by physical activity. Methods: We constructed an aggregate measure of NSES using census-based indicators of wealth, education, and occupation and quantified distribution-based tertiles of low, middle, and high NSES among ARIC cohort participants in Visit 5 (2011-2013). We used the Rosow-Breslau scale to ascertain functional status (range 0-4; functional impairment defined as a score&lt;4) during the 2016 annual telephone interview. Multivariable logistic regression was used to examine the association between NSES tertiles and functional status impairment adjusting for age, race, ARIC center, and sex. We tested for effect modification by AHA-defined physical activity (categorized as poor, intermediate, ideal based on weekly minutes of moderate-to-vigorous physical activity). We also tested for effect modification by sex, race, and age. Results: Among 4,439 participants (mean age: 75 (SD 5) years, 22% Black, 55% female), 1,788 (40%) had functional status impairment. In analyses adjusted for sex, race, and age, the odds of functional impairment among participants with low NSES were 1.86 (95% CI: 1.60, 2.16) times the odds of functional impairment among those with high NSES. There was evidence of effect measure modification by race (p=0.06) and age (p=0.07). In White participants, the odds of functional status impairment among participants with low NSES was 1.99 (95% CI: 1.69, 2.35) times the odds of functional impairment among those with high NSES. This association was attenuated in Black participants (OR: 1.38, 95% CI: 0.96, 2.00). In participants less than 74 years, the odds of functional status impairment among participants with low NSES was 2.17 (95% CI: 1.73, 2.72) times the odds of functional impairment among those with high NSES. This association was attenuated in participants 74 years and older (OR: 1.64, 95% CI: 1.34, 1.99). There was no evidence of effect modification by physical activity (p=0.20) nor sex (p=0.65). Conclusions: Low NSES is modestly associated with functional status impairment in older adulthood. This association appeared stronger in Whites compared to Blacks, and in those younger than 74 years.
Abstract P127: Early Life Adversity and Obesity Risk in Adolescence: A 9-year Population-Based Prospective Cohort Study
Authors: Hannah Steinman De Visser, Nicole Brunton, Brenden Dufault, Jonathan M McGavock
Journal: Circulation (2023)

Objective: We previously found that exposure to adverse childhood experiences (ACEs) is associated adolescent obesity. This study was designed to identify mediators of this association. We hypothesized that exposure to adverse experiences before 9 yrs would be associated with an increased risk of obesity at 18 yrs, and that behavioural and emotional factors would mediate this association. Methods: In 2007/2008, 8568 nine-year-olds were randomly sampled, enrolled in the Growing up in Ireland cohort study and followed in 18 yrs. The main exposures were 14 adverse experiences including four of the traditional ACEs before 9 years of age, self-reported by the primary care giver. The main outcome, body mass index (BMI) was measured objectively at 18 yrs. Mediators were self-reported daily activity, soda intake, self-image (Piers Harris) and behavioural difficulties (Strengths and Difficulties Questionnaire) at 9 and 13 yrs. Co-variates were household income and primary caregiver BMI. Structural equation models (SEMs) tested for mediators of the association between exposure to adverse experiences and ACEs before 9 yrs and BMI at 18 yrs. Results: Among the 6039 adolescents with complete data, 76% experienced any adversity, 14% experienced an ACE, 49% were female and 27% were overweight/obese at 18 yrs. BMI Z score was higher at ages 9 (0.47 vs 0.36, p &lt; 0.05) and 13 yrs ( 0.39 vs 0.29, p &lt; 0.05) in those exposed to an adverse experience or an ACE, compared to those unexposed. Behavioural difficulties were higher and self image was lower at all three time points for those exposed to any adversity or an ACE, compared to those unexposed. SEMs revealed that behavioural difficulties and self concept, but not exercise or soda intake, modestly mediate the association between exposure to adverse experiences and BMI at 18 years (Figure 1). Conclusion: Exposure to any adversity or ACEs are not directly associated BMI at 18 yrs. Behavioural difficulties and self-concept weakly mediate the association between adverse childhood experiences and BMI at 18yrs.
Abstract P532: Risk Factor Differences for Coronary Artery Calcium in Self versus Provider-Referred Groups
Authors: Rebekah Lantz, Srikanth Sadhu
Journal: Circulation (2023)

Introduction: To detect coronary artery disease (CAD) in asymptomatic patients, noninvasive coronary artery calcium (CAC) computed tomography (CT) can be used in the decision to start statin or further lipid lowering management. The test is appropriate for adult patients 40-75 years old at 10-year atherosclerotic cardiovascular disease intermediate risk (7.5-20%) without diabetes mellitus and with low-density lipoprotein cholesterol 70-189 mg/dL. The study was to identify risk factor differences between self and provider-referred groups. We hypothesized that the provider-referred group would have greater risk factors. Methods: Patients who received CAC CT at seven southwest Ohio hospitals for the first 6 months of 2019 were self or provider-referred for CAC CT during a community campaign for persons who identified as having cardiovascular risk factors. Their background information and labs were obtained and compared to ascertain differences. Results: The analyses involved 2124 patients who received CAC CT. 163 were self and 1961 were provider-referred. With 30 demographic and clinical risk factors compared, peripheral vascular disease, higher triglyceride levels, higher LDL and beta blocker prescription were associated with higher odds for elevated CAC score in the self-referred group. There was no difference between white or black races. Conclusion: CAC CT testing can be used to clarify cardiovascular risk and to optimize medical therapy for both self and provider-referred groups. Self-referred patients seem to identify with similar or advanced awareness of risk factors for primary prevention concerns when a community initiative was issued. Therefore, community initiatives may have a public health benefit for primary prevention and early detection of cardiac risk. This is a study that may be repeated in other communities.
Abstract 69: Dietary Fiber, Gut Microbiota, Circulating Metabolomics, and Risk of Diabetes in US Hispanics/Latinos: The Hispanic Community Health Study/Study of Latinos (HCHS/SOL)
Authors: Zheng Wang, Jiaqian Xing, Brandilyn A Peters, Bing Yu, Megan Grove, Gang Hu, Tao Wang, Bharat Thyagarajan, Martha L Daviglus, Eric Boerwinkle, Daniela Sotres-Alvarez, Rob Knight, Robert D Burk, Robert Kaplan, Qibin Qi
Journal: Circulation (2023)

Introduction: Emerging evidence suggesting diabetes -protective effects of dietary fiber intake. However, the underlying mechanisms are not fully understood. Hypothesis: We hypothesize that higher dietary fiber intake can alter gut microbial composition /functional capacity and host circulating metabolomic profile, which may contribute to lower risk of diabetes. Methods: We evaluated the associations of dietary fiber intake with gut microbiome (measured by shotgun metagenomic sequencing, n=2959) and serum metabolome (639 metabolites measured by untargeted metabolomic approach, n=6198) in the HCHS/SOL cohort. We further examined prospective associations of baseline fiber/microbial-associated metabolites with incident diabetes over 6-years follow-up. Results: We identified 39 bacterial genera associated with fiber intake, after adjustment for sociodemographic, behavioral, and clinical factors. 12 of these fiber-associated genera were related with diabetes (e.g. the fiber-associated Roseburia was inversely associated with diabetes, Fig.1A ). We identified 83 fiber-associated metabolites which were clustered into 13 modules in network, 7 of which were significantly associated with risk of diabetes ( Fig.1B ). Some of these diabetes-associated metabolite modules were also associated with fiber/diabetes-associated bacterial taxa ( Fig.1C ). In particular, indolepropionate module, and another module comprised of the pro-vitamins such as beta-cryptoxanthin, were positively associated with fiber (all P&lt;0.001) and inversely associated with diabetes risk (RR [95% CI] = 0.78[0.69, 0.89] and 0.83[0.72, 0.94] respectively), and both associated with the fiber-degradation genera Butyrivibrio (P&lt;0.001). Conclusion: Among US Hispanics/Latinos, higher fiber intake was associated with favorable profiles of gut microbiota and circulating metabolites for diabetes, suggesting a potential role of gut microbiota and related metabolites in the link between dietary fiber intake and risk of diabetes.